FDA Adverse Event Injury Summary report: N

SUBTALAR M.B.A.

MDR report key: 443958 · Received February 14, 2003

Report

Report Number
2028840-2003-00011
Event Type
Injury
Date Received
February 14, 2003
Date of Event
February 7, 2003
Report Date
February 13, 2003
Manufacturer
KINETIKOS MEDICAL, INC.
Product Code
HRS
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

ON FEB 12, 2003, KMI WAS NOTIFIED OF THE EXPLANT OF A SIZE 10MM SUBTALAR M.B.A. TO ADDRESS PAIN REPORTED BY THE PATIENT. THE PRIMARY SURGEON INDICATED THE DEVICE WAS AN INCORRECT SIZE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SUBTALAR M.B.A. ORTHOPAEDIC FOOT IMPLANT HRS KINETIKOS MEDICAL, INC. 05-0110 7688-7786

Patients

Seq Age Sex Outcome Treatment
1 29 YR Other